Ellen Selman Lucy, Fox Fiona, Aabe Nura, Turner Katrina, Rai Dheeraj, Redwood Sabi
a School of Social and Community Medicine, Faculty of Health Sciences , University of Bristol , Bristol , UK.
b The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust , Bristol , UK.
Ethn Health. 2018 Oct;23(7):781-796. doi: 10.1080/13557858.2017.1294663. Epub 2017 Mar 2.
Social stigma is commonly experienced by parents of children with autism. Our aim was to understand the nature of stigma experienced by Somali parents of children with autism in the United Kingdom (UK), and to consider how they coped with or resisted such stigma.
We used a community-based participatory research approach, collaborating with a community organisation of Somali parents. In-depth interviews with simultaneous translation were conducted with 15 Somali parents of children with autism living in Bristol, UK, in 2015. Parents were sampled purposively to capture diversity in children's age, severity of autism and time since diagnosis. Directed thematic analysis used Link and Phelan's model of stigma.
Of the 15 participants, 12 were mothers (mean age 36). The 17 children with autism they cared for were 4-13 years' old, and five were girls. Two main themes with sub-themes were identified: the nature of stigma (labelling and stereotyping; separation; emotional reactions, discrimination and power), and coping and resistance (the power of language; faith as a resource; learning, peer support and community relationships). Children with autism were labelled and stereotyped (e.g. as 'sick', 'naughty', 'different') and parents blamed for not controlling them, leading to social rejection and isolation. Stigma was associated with a poor understanding of autism, a lack of vocabulary related to autism in the Somali community, and prejudice against mental illness and disability. There was evidence of enacted and felt stigma and examples of discrimination. Finding their own language to describe their child's condition and drawing on faith, learning and peer support were important resources in resisting stigma.
Findings inform support for this community, highlighting the need to raise awareness of autism, enable parents to speak openly, and ensure appropriate professional services and interventions are available.
自闭症儿童的家长普遍遭受社会污名化。我们的目的是了解英国索马里裔自闭症儿童家长所经历的污名化的本质,并探讨他们如何应对或抵制这种污名化。
我们采用了基于社区的参与式研究方法,与一个索马里裔家长社区组织合作。2015年,对居住在英国布里斯托尔的15位索马里裔自闭症儿童家长进行了同步翻译的深入访谈。家长是经过有目的抽样选取的,以涵盖儿童年龄、自闭症严重程度以及确诊后的时间等方面的多样性。采用林克和费伦的污名模型进行定向主题分析。
15名参与者中,12名是母亲(平均年龄36岁)。她们照顾的17名自闭症儿童年龄在4至13岁之间,其中5名是女孩。确定了两个主要主题及子主题:污名化的本质(标签化与刻板印象;隔离;情绪反应、歧视与权力),以及应对与抵制(语言的力量;信仰作为一种资源;学习、同伴支持和社区关系)。自闭症儿童被贴上标签并受到刻板印象的影响(如被视为“生病的”“调皮的”“与众不同的”),家长被指责没有管教好他们,导致社会排斥和孤立。污名化与对自闭症的理解不足、索马里社区中缺乏与自闭症相关的词汇,以及对精神疾病和残疾的偏见有关。有证据表明存在实际的和感受到的污名化以及歧视的例子。找到自己的语言来描述孩子的状况,并借助信仰、学习和同伴支持,是抵制污名化的重要资源。
研究结果为支持这个社区提供了依据,强调了提高对自闭症的认识、使家长能够公开谈论,以及确保提供适当的专业服务和干预措施的必要性。